Use of omental pedicle for treatment of Buerger's disease affecting the upper extremities. A modified technique.
We present a report of a 58-year-old male patient who suffered from Buerger's disease of the upper extremities verified by microscopy and angiography. Despite medical treatment and repeated thoracic sympathectomy he developed gangrene at the tip of his right thumb and index finger. Pedicled omentum was prepared through midline laparatomy, placed through subcostal incision to the subcutaneous space of the forearm and affected fingers. Rest pain disappeared by the fifth day after surgery. The omental pedicle was ligated six weeks post-operatively and the extremity mobilized. The thumb healed well. The index finger required amputation because of continuing infection. Five years postoperatively the patient has a good functioning hand in which the transferred omentum has retained its viability.
Ala-Kulju
K
K
Department of Thoracic and Cardiovascular Surgery, Helsinki University Central Hospital, Finland.
Virkkula
L
L
D000792:Angiography; D006225:Hand / Q000098:blood supply*; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009852:Omentum / Q000098:blood supply / Q000637:transplantation*; D013524:Surgical Flaps / Q000379:methods*; D013919:Thromboangiitis Obliterans / Q000601:surgery*